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Adult Health 1 - (Josh) > T3 - Assessment of Nervous System (Josh) > Flashcards

T3 - Assessment of Nervous System (Josh) Flashcards

1
Q

How many layers are in the scalp?

A

3

middle layer is where blood vessels are

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2
Q

What volume can the avg skull hold?

A

1400-1500 mL

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3
Q

Fossae:

Which lobes are within the Anterior Fossae?

A

Frontal

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4
Q

Fossae:

Which lobes are within the Middle Fossae?

A

Temporal
Parietal
Occipital

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5
Q

Fossae:

Which areas of brain are found in Posterior Fossae?

A

Brainstem

Cerebellum

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6
Q

What are the 3 major divisions of the brain?

A

Cerebrum

Brainstem

Cerebellum

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7
Q

What are the lobes of the Brain?

A 
Frontal
Parietal
Temporal
Occipitol
Limbic
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8
Q

Where is the respiratory center located?

A

Brainstem

  • Midbrain
  • Pons
  • Medulla
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9
Q

Which area of the brain takes over learned, repetitive tasks like riding a bicycle?

A

Cerebellum

  • provides smooth, coordinated body mvmt
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10
Q

Which lobe?

  • Voluntary eye mvmt
  • Access to sensory data
  • Affective response to judgement
  • Regulated behavior based upon judgment
  • Judgment
  • Long-term goals
  • Reasoning, concentration, abstraction
A

Frontal Lobe

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11
Q

Where is the Motor Strip for the opposite side of body located?

A

Frontal lobe

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12
Q

Where is Broca’s Area?

A

Frontal lobe

  • inferior frontal gyrus
  • responsible for MOTOR aspects of speech
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13
Q

What will damage to Broca’s Area cause?

What will damage to auditory center in Temporal lobe cause?

A

Expressive Aphasia

Receptive Aphasia

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14
Q

Which lobe receives data from skin: pain, heat, cold, pressure?

A

Parietal

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15
Q

Which lobe processes sensory of spacial awarenes and is used in hand-eye coordination?

A

Parietal

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16
Q

Which lobe contains the sensory strip for the opposite side of the body?

A

Parietal

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17
Q

Where is the Auditory center located?

A

Temporal Lobe

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18
Q

Which lobe has the special senses of taste and smell?

A

Temporal Lobe

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19
Q

Which lobe?

  • Memory
  • Understanding Music
  • Aggressiveness
  • Sexual Behavior
A

Temporal Lobe

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20
Q

Which lobe is most likely the site of seizure activity?

A

Temporal Lobe

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21
Q

Which lobe regulates emotion and memory?

A

Limbic

  • involved in formation of long-term memories
  • closely associated with olfactory structures
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22
Q

What is the Diencephalon?

A

posterior part of forebrain that connects the midbrain with the cerebral hemispheres

***encloses the third venticle

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23
Q

What is housed inthe Diencephalon?

A 
Thalamus
Hypothalamus
Epithalamus
Pineal Gland
Pituitary Gland
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24
Q

What is referred to as the ‘gateway’ to cerebral cortex and serves as a relay station from sensory inputs to higher levels of brain?

A

Thalamus

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25
Q

Which area of brain has controls for the following:

  • Temp
  • Food and Water intake
  • Behavior
  • Autonomic Responses
  • Hormonal Secretion of Pituitary Gland
  • Visible Physical Expressions (Limbic System)
A

Hypothalamus

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26
Q

How many ventricles and what do they contain?

A

4 total: 2 lateral, 1 central, 1 at bottom of brain

contain CSF

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27
Q

If the longitudinal fissure is not midline, we should suspect what?

A

increased pressure in one hemisphere shifting it the other way

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28
Q

If the Lateral or Central Fissures look smooth, we should suspect what?

A

increased pressure

  • they should be wrinkled
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29
Q

What are the 12 Cranial Nerves?

A 
I: Olfactory
II: Optic
III: Occulomotor
IV: Trochlear
V: Trigeminal
VI: Abducens
VII: Facial
VIII: Vestibulocochlear
IX: Glossopharyngeal
X: Vagus
XI: Accessory
XII: Hypoglossal
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30
Q

In the neuro status exam, what is the order of severity?

A 
Alert
Confused
Delirious
Lethargic
Obtunded
Stuporous
Comatose
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31
Q

If pupils have an irregular shape, such as oval-shaped, what should we suspect?

A

increased pressure on that cranial nerve

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32
Q

What is the Best Score for GCS?

What is worst score?

A

15

3 (even if braindead)

33
Q

What is the order for GCS?

A

E4 - Eye Opening
V5 - Verbal Response
M6 - Motor Response

34
Q

GCS:

What is the scores for Eye Movment?

A

Spontaneous eye opening = 4

Eye open to speech = 3

Eye open to pain (stimulus) = 2

No eye opening = 1

35
Q

GCS:

What are the scores for Verbal Response?

A

Oriented = 5

Confused over conversation = 4

Inappropriate conversation = 3

Incomprehensible speech = 2

No speech = 1

36
Q

GCS:

What are the scores for Motor Response?

A

Obeys commands = 6

Localizes response to pain = 5

Generalized withdrawal to pain = 4

Flexor posturing to pain = 3

Extensor posturing to pain = 2

No response to pain = 1

37
Q

GCS:

What is localization?

A

attempt to remove or stop the painful stimuli

38
Q

GCS:

What is withdrawal?

A

attempt to avoid the painful stimuli

39
Q

Patient teaching for Cerebral Angiogram?

A

NPO 4-6 hrs

Assess for shellfish or iodine allergy

Assess BUN and kidney function due to dye

No jewelry

Mild sedative used

Closely monitor puncture site post-procedure

40
Q

Patient teaching for CT Scan?

A

NPO 4 hrs

Shellfish or iodine allergy

BUN, Crit, and kidney function

No jewelry

Small pillow for back since in supine position

painless (no follow-up care needed, though sedation available of anxious)

41
Q

Patient teaching for EKG?

A

Takes about an hour

Hold anticonvulsants

Wash hair prior to procedure

Be SLEEP DEPRIVED

May be exposed to bright flashing lights or asked to hyperventilate for 3-4 mins

Normal activities can be resumed post-procedure

42
Q

Which clients are candidates for ICP Monitoring?

A

comatose of GCS of 8

43
Q

What is normal ICP?

A

10-15 mmHg

44
Q

Nursing care for ICP Monitoring?

A

Inspect insertion site q day

Neuro checks q hr

Keep drainage system closed

Irrigate only as needed

Limit to 3-5 days max

45
Q

Nursing care for MRI Scan?

A

NPO 4-8 hrs

Pillows in small of back

No follow-up care needed, unless sedation was used for claustrophobia or contrast media was used

46
Q

—- uses a glucose based tracer so we must monitor for hyper-hypoglcemia and assess history of DM.

A

PET Scan

***painless and sedation rarely necessary

47
Q

How many spinal nerves?

A

31

  • 7 Cervical
  • 12 Thoracic
  • 5 Lumbar
  • 5 Sacral
  • 1 Coccyx
48
Q

Which part of Spinal Cord is myelinated and contains the ascending and descending tracts?

A

White Matter

49
Q

Which part of Spinal Cord is unmyelinated and contains Anterior, Lateral, and Posterior Horns?

A

Grey Matter

  • central part of SC
50
Q

The Dorsal Root is on the — side of body and is an — pathway.

A

Posterior

Afferent (enters the cord = adds)

51
Q

The Ventral Root is on the — side of body and is an — pathway.

A

Anterior

Efferent (exits)

52
Q

— — conveys sensory input from specific areas of body (dermatomes) into the spinal cord and up to brain.

A

Dorsal Root

53
Q

— — conveys impulses from spinal cord to different parts of body.

A

Ventral Root

54
Q

Which tract?

Carries sensory info to the brain.

A

Ascending tract

55
Q

Which tract?

Carries impulses from brain.

A

Descending tract

56
Q

What are the Three Major Ascending Tracts?

A

Spinothalamic

Spinocerebellar

Posterior Column Tract

57
Q

Which Ascending Tracts convey impulses from OPPOSITE side?

Which ones from SAME side?

A

Opposite:

  • Spinothalmic
  • Posterior Column Tract

Same:
- Spinocerebellar

58
Q

Ascending Tracts:

Which tract carries sensations for CRUDE TOUCH and PRESSURE from opposite side of body?

A

Anterior Spinothalamic

59
Q

Ascending Tracts:

Which tract carries sensations for PAIN and TEMP from opposite side of body?

A

Lateral Spinothalamic

60
Q

Ascending Tracts:

Which tract carries info for PROPRIOCEPTION?

A

Spinocerebellar

61
Q

Ascending Tracts:

Which tract carries info for PROPRIOCEPTION, as well as FINE TOUCH, PRESSURE, and VIBRATION for opposite side of body?

A

Posterior Column Tract

62
Q

Descending Tracts:

Where does the Corticospinal Tract originate?

A

motor cortex of FRONTAL LOBE and portions of PARIETAL LOBE

63
Q

Which tract has conscious control of skeletal muscle?

A

Corticospinal Tract

***a descending tract

64
Q

Which tract doesn’t need to ascend up spinal cord to illicit a response?

A

Reflex Arc

65
Q

Which neurons are located entirely in CNS and facilitate/inhibit descending supraspinal pathways?

A

UMN (Upper Motor Neurons)

66
Q

Which neurons are located in CNS and PNS and serve as a linkage b/t CNS and voluntary muscles?

A

LMN (Lower Motor Neurons)

67
Q

Which Motor Neuron syndrome has SPASTIC paralysis?

Which Motor Neuron syndrome has FLACCID paralysis?

A

UMN Syndrome

LMN Syndrome

68
Q

S/S of UMN Syndrome:

A

Weakness, paralysis

Spasticity

Increased tendon reflexes

Positive Babinski

Loss of Abdominal reflexes

Little of no muscle astrophy

69
Q

S/S of LMN Syndrome:

A

Motor weakness

Wasting and Fasciculations of muscles

Hypotonia (flaccid paralysis)

Loss of tendon reflexes

70
Q

Where would a Lumbar Puncture be done?

A

L4-L5

71
Q

What is the Glucose value of CSF?

A

50-75 mg/dL

***two-thirds of blood sugar value

72
Q

What is volume of CSF:

A

135-150 mL

73
Q

An injury in the — Fossae is very serious.

A

Posterior

**where brainstem and cerebellum is

74
Q

Where are CSF and Cerebral arteries located?

A

Subarachnoid Space

75
Q

Which lobe may have auditory, visual, and sensory hallucinations?

A

Temporal

76
Q

The — — is responsible for blushing, dry mouth, clammy hands and other visible expressions of anxiety.

A

Limbic System

77
Q

Client with traumatic brain injury with a temp of 104 F and no signs of infection likely has an injury where?

A

Limbic System

78
Q

Dermatomes:

— is the nipple line.

A

T4

79
Q

What is the most common cause of changes in an older adult’s mental status?

A

insufficient O2

Adult Health 1 - (Josh) (26 decks)

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